{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T00:31:40Z","timestamp":1759624300465,"version":"build-2065373602"},"reference-count":26,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Sanhang Talent program of Naval medical university","award":["25TPSL0003"],"award-info":[{"award-number":["25TPSL0003"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82300235"],"award-info":[{"award-number":["82300235"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Shanghai Municipal Health Commission Talent Plan Youth Project","award":["2022YQ031"],"award-info":[{"award-number":["2022YQ031"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["SAGE Open Medical Case Reports"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n            To report the management and outcome of an elderly, high-risk lymphoplasmacytic lymphoma\/Waldenstr\u00f6m macroglobulinemia patient presenting with severe symptomatic anemia, marked hyperleukocytosis, a complex karyotype, dual\n            <jats:italic>MYD88\/CXCR4<\/jats:italic>\n            mutations, and significant comorbidities, highlighting the therapeutic challenges and the efficacy of targeted therapy after chemoimmunotherapy intolerance. This case report details a 78-year-old male diagnosed with high-risk lymphoplasmacytic lymphoma\/Waldenstr\u00f6m macroglobulinemia (\n            <jats:italic>MYD88<\/jats:italic>\n            L265P\n            <jats:sup>+<\/jats:sup>\n            , pathogenic\n            <jats:italic>CXCR4<\/jats:italic>\n            <jats:sup>+<\/jats:sup>\n            , complex karyotype: 46,X,-Y,add(6)(q224),+18\/47,XY,+18\/47,X,Y,+4,+18\/48,XY,+4,+18\/48,XY,+3,+18\/46,XY) and significant comorbidities including hypertension and suspected cardiac amyloidosis. Initial treatment with bendamustine\u2013rituximab was administered but led to significant toxicity. Subsequently, therapy was switched to the second-generation Bruton\u2019s tyrosine kinase inhibitor, zanubrutinib. Clinical progress, hematologic response, and adverse events were monitored. Initial treatment with bendamustine\u2013rituximab was discontinued due to severe toxicity, including a grade 3 infusion reaction and subsequent neutropenic fever. Following the switch to zanubrutinib, he achieved a sustained partial hematologic response and clinical improvement. Disease-related complications (hyperviscosity retinopathy) and treatment-related adverse events (neutropenia) occurred but were managed appropriately while continuing zanubrutinib. Zanubrutinib demonstrated efficacy and manageable toxicity in an elderly, high-risk lymphoplasmacytic lymphoma\/Waldenstr\u00f6m macroglobulinemia patient with a complex karyotype, dual\n            <jats:italic>MYD88\/CXCR4<\/jats:italic>\n            mutations, hyperleukocytosis, and significant comorbidities, following intolerance to standard chemoimmunotherapy. This case supports the use of targeted Bruton\u2019s tyrosine kinase inhibition in achieving favorable outcomes in complex lymphoplasmacytic lymphoma\/Waldenstr\u00f6m macroglobulinemia presentations and contributes to understanding the significance of complex karyotypes in the era of novel therapies.\n          <\/jats:p>","DOI":"10.1177\/2050313x251381565","type":"journal-article","created":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T10:58:01Z","timestamp":1759316281000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Zanubrutinib for high-risk Waldenstr\u00f6m macroglobulinemia with complex karyotype and hyperleukocytosis: A case report and literature review"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-7900-5038","authenticated-orcid":false,"given":"Jiale","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jieyi","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengyang","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jie","family":"He","sequence":"additional","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hematology, Navy Medical Center of PLA, Naval Medical University, Shanghai, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pathol.2019.09.009"},{"issue":"44","key":"e_1_3_2_3_2","first-page":"745","article-title":"Monoclonal IgM gammopathy and Waldenstrom\u2019s macroglobulinemia","volume":"114","author":"Grunenberg A","year":"2017","unstructured":"Grunenberg A, Buske C. 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